Blood Flow Restriction Training

What is Blood Flow Restriction (BFR) rehabilitation? The complicated answer stands as a brief intermittent occlusion of venous blood flow, using a specialized tourniquet while exercising. The goal is to reduce enough blood flow to create positive changes, not only in the working muscle but also systemically throughout the body. The application of a BFR tourniquet must be specialized and take into account the size of the limb, density of the soft tissue in the limb, blood pressure, changes in blood pressure during exercise, and placement and width of the cuff. So it’s very important to undergo BFR rehabilitation with a trained and licensed medical professional.

The primary goal of Blood Flow Restriction training is to induce strength and hypertrophy in working muscles, by way of very low resistance and loads. Traditionally, in order to make strength and hypertrophy gains heavy loads and a lot of resistance are required. According to the American College of Sports Medicine, in order to optimize strength and hypertrophy, moderate to high intensity resistance exercises are required. These exercises should target the body’s major muscle groups 2-3 times a week at an intensity of 65% of someone’s one rep maximum (1RM = the amount of weight someone can lift just one time). Basically, in order to gain strength and build muscle, you would have to lift heavy weights most days of the week.

Unfortunately, the elderly or people rehabilitating from an injury may not be able to tolerate this much weight, which can hinder their ability to gain strength and increase muscle, and ultimately get healthier. There have been multiple studies that show the combination of blood flow occlusion and low level exercises (think bodyweight exercises) can induce strength and hypertrophy, similar to someone lifting heavy weights most days of the week. The exact mechanism of why this happens is still under study but the research has consistently shown that there are significant gains from blood flow restriction for strength and hypertrophy. Some of the current theories as to the mechanism of BFR includes muscle fiber type recruitment, metabolic by-product accumulation, activation of muscle protein synthesis, and cell swelling. Usually most of these mechanisms are present in individuals who lift heavy weights.

So who is BFR training useful for? As mentioned above, individuals who are older yet still active and those recovering from surgery or injury, because they may not be able to lift the required loads in order to regain their strength. Also, those fresh out of hip, knee, or ankle surgery may have weight bearing restrictions that prevent them from lifting heavy loads or performing traditional squat or deadlift workouts. With a BFR rehabilitation protocol, you will not need to bear weight, let alone lift heavy loads in order to make similar gains as someone in the gym who is lifting heavy weights. It’s important to remember only trained and licensed healthcare providers can administer BFR training. To find a certified provider near you, visit: